High-risk human papillomavirus enhances theexpression ofCOX-2 VEGF, EGFR, ProEx-C, and TERT proteins in human papillomavirus-related multiphenotypic sinonasal carcinoma through activation ofPI3K/Akt, pRb, and TERT signalling pathways.

Abstract

Human papillomavirus (HPV)-related multiphenotypic sinonasal carcinoma (HMSC) is anew type ofsinonasal tumour that frequently drops out ofaccurate diagnosis. Human papillomavirus related multiphenotypic sinonasal carcinoma was previously known as HPV-related sinonasal carcinoma with adenoid cystic characteristics, and it is connected to high-risk HPV (HR-HPV) strains whose prognosis is unknown. We aim to evaluate PI3K/Akt, pRb, and htelomerase reverse transcriptase (TERT) signalling pathway activation through theexpression ofproteins cyclooxygenase-2 (COX-2), vascular endothelial growth factor (VEGF), ProEx-C, and TERT and their prognostic and clinicopathological value in HMSC patients. Sections ofthe40 paraffin blocks ofHMSC were recovered, and all samples were evaluated for thepresence ofacocktail ofHR-HPV, and theabsence ofMYB, NFIB, and MYBL1 fusions using fluorescence in situ hybridization; thepresence ofmyoepithelial markers; S100, actin; thepresence ofsquamous differentiation markers; calponin, p40, and p63 using PCR-based assays; and COX-2,VEGF, ProEx-C, and TERT using immunohistochemical staining. All patients were monitored for around 54 months, until death, or thelast known surviving data (range 20-60 months). Astatistically significant relationship exists between COX-2 expression was significantly related to theold age group, tumour extent, relapse, mortality, and poor DFS; (p = 0.001), (p = 0.01), (p = 0.002), and (p = 0.035), respectively. While VEGF, ProEx-C, and TERT expression with theold age group, tumour extent, lymph node metastasis, advancedstaging, relapse, mortality, poor disease free survival (DFS), and overall survival (p = 0.001). Human papillomavirus-related multiphenotypic sinonasal carcinoma is aunique sinonasal neoplasm with astrong link to HR-HPV strains. Expression ofCOX-2, VEGF, EGFR, ProEx-C, TERT was linked to poor prognosis, survival, and aggressive malignant behaviours such as proliferation, local recurrence, and lymph node metastasis, making them novel beneficial biomarkers and targeted therapies for HMSC patients.